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Published on: July 4, 2013
Self-injury, aggression and destruction in children with severe intellectual disability: Incidence, persistence and
1Finch Road Primary Care Centre, Finch Road, Lozells, Birmingham B19 1HS, UK.
Insights
Repetitive behaviors and impulsivity are significant risk markers for self-injury, aggression, and destruction in children with severe intellectual disability. Early intervention strategies targeting these behaviors are crucial for this high-risk population.
Area of Science:
- Child Psychology
- Developmental Disabilities
- Behavioral Science
Background:
- Severe intellectual disability (ID) in children presents challenges, including self-injurious, aggressive, and destructive behaviors.
- Early intervention strategies are increasingly supported for managing these behaviors in high-risk children.
- Understanding predictive risk markers is crucial for effective intervention.
Purpose of the Study:
- To determine the cumulative incidence and persistence of self-injury, aggression, and destruction in children with severe ID.
- To investigate the relationship between these behaviors and risk markers: repetitive behaviors and interests (RRBI), and impulsivity/overactivity (O/I).
Main Methods:
- A longitudinal study design was employed.
- 417 children with severe ID were assessed by teachers.
- Assessments were conducted twice, with a 15-18 month interval, measuring self-injury, aggression, and destruction.
Main Results:
- Aggression, destruction, and self-injury showed high persistence rates (69%, 57%, 58% respectively).
- Both RRBI and O/I were significantly associated with aggression, destruction, and/or self-injury.
- RRBI and O/I significantly increased the relative risk for the cumulative incidence of these behaviors.
Conclusions:
- Repetitive and restricted behaviors and interests (RRBI) and overactivity/impulsivity (O/I) are confirmed as risk markers.
- These markers predict the onset of self-injury, aggression, and destruction in children with severe ID.
- Findings support risk-informed early intervention for this vulnerable group.
Background:
A risk informed, early intervention strategy for self-injurious, aggressive and destructive behaviours in children with severe intellectual disability is gaining support. The aims of this study were to establish the cumulative incidence and persistence of self-injury, aggression and destruction and the relationship between these behaviours and two potentially predictive behavioural risk markers (repetitive behaviour, and impulsivity and overactivity) in children at high risk.
Methods:
In a longitudinal design self-injury, aggression and destruction were assessed by teachers of 417 children with severe intellectual disability on two occasions separated by 15-18 months.
Results:
Aggression, destruction and self-injury were persistent (69%, 57% and 58% respectively). Repetitive and restricted behaviours and interests (RRBI) and overactivity/impulsivity (O/I) were significantly associated with aggression (O/I OR=1.291, p<.001), destruction (RRBI OR 1.201, p=.013; O/I OR 1.278, p<.001) and/or self-injury (RRBI, OR 1.25, p=.004; O/I OR=1.117, p<.001). The relative risk of the cumulative incidence of self-injury, aggression and destruction was significantly increased by repetitive and restricted behaviours and interests (self-injury 2.66, destruction 2.16) and/or overactivity/impulsivity (aggression 2.42, destruction 2.07).
Conclusions:
The results provide evidence that repetitive and restricted behaviours and interests, and overactivity/impulsivity, are risk markers for the onset of self-injury, aggression and destruction within the already high risk group of children with severe intellectual disability.
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